Bronchitol Initiation Dose Assessment
Adult

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Useful Management Information

The inhalation of bronchitol (mannitol) is intended to improve lung hygiene by correcting impaired mucociliary clearance that is characteristic of cystic fibrosis.

Indications:

Bronchitol is indicated for the treatment of cystic fibrosis in both paediatric and adult cystic fibrosis populations six years and above, as either an add-on therapy to dornase alfa (pulmozyme) or in patients intolerant to, or inadequately responsive to dornase alfa. Before commencing treatment with bronchitol, all patients must undergo a BIDA to be assessed for bronchial hyperresponsiveness.

Contraindications:

A baseline FEV1 ≤30% of predicted.
Hypersensitivity to mannitol or to the gelatin capsule containing mannitol.
The patient is pregnant and/or breastfeeding.
Patients below 6 years of age.
Acute myocardial within 1 week.
Systemic hypotension or severe hypertension.
Significant atrial/ventricular arrhythmia.
Non-compensated heart failure.
Uncontrolled pulmonary hypertension.
Acute cor pulmonale.
Clinically unstable pulmonary embolism.
History of syncope related to forced expiration/cough.
Cerebral aneurysm.
Brain surgery within 4 weeks.
Recent concussion with continuing symptoms.
Eye surgery within 1 week.
Sinus surgery or middle ear surgery or infection within 1 week.
Presence of pneumothorax.
Thoracic surgery within 4 weeks.
Abdominal surgery within 4 weeks.
Late term pregnancy.
Active or suspected transmissible respiratory or systemic infection including tuberculosis.
Physical conditions predisposing to transmission of infections.

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category Category 1 ((appointment within 30 calendar days))	Requires tests within 30 days.
Category Category 2 ((appointment within 90 calendar days))	Requires tests within 90 days.
Category Category 3 ((appointment within 365 calendar days))	Requires tests within 365 days.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Reason for referral - what is the clinical question to be answered by performing the test?
Current respiratory medications
Infectious status.

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

No additional referral information

Send Referrals To

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Facilities

No facilities listed

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Bronchitol Initiation Dose AssessmentAdult